FORM 1023-EZ for INDIE LAB

Field Data
EIN 47-2022094
Case Number EO-2015035-000169
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INDIE LAB
Organization’s Mailing Address 1600 ROSENEATH RD STE E
City RICHMOND
State VA
ZIP 23230-4449
Accounting period End 10
Primary contact name JOHN SLAVIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOHN SLAVIN
DIRECTOR
2310 HARVIE RD
RICHMOND VA 23223-1710

Officer/Director/Trustee Two

ELLIOT ROTH
SECRETARY
218 W MAIN ST APT B
RICHMOND VA 23220-5628

Officer/Director/Trustee Three

GRACE CUMMINGS
TREASURER
104 W FRANKLIN ST APT 805
RICHMOND VA 23220-5002

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/7/2014
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code U20 - Science, General
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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